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Erectile dysfunction - Viagra | Kamagra | Cialis | Dapoxetine

In 70 percent of cases, physical causes are responsible for erectile dysfunction. Most often, penile blood circulation is disturbed and / or the penile gland itself, which is very similar to the vascular wall musculature, falls ill. Either too little blood in the penis arrives because...

Erectile dysfunction - Viagra | Kamagra | Cialis | Dapoxetine

In 70 percent of cases, physical causes are responsible for erectile dysfunction. Most often, penile blood circulation is disturbed and / or the penile gland itself, which is very similar to the vascular wall musculature, falls ill. Either too little blood in the penis arrives because the supplying arteries are "calcified" (arteriosclerosis). Or the blood drains off too quickly through the veins. Or both. In any case, the amount of blood in the erectile tissue of the penis is no longer sufficient for a satisfactory erection.

Circulatory disorders

Various diseases that promote circulatory disorders also increase the risk of erectile dysfunction: Diabetes mellitus (diabetes), hypertension, lipid metabolism disorders. The lifestyle also has a decisive influence: Smoking, obesity, physical inactivity and a one-sided and unhealthy diet increase the blood vessels and thus increase the probability of potency problems. Conversely, a healthy lifestyle helps to prevent potency disorders. It has also been shown repeatedly that a healthy lifestyle and regular exercise exercise a favorable influence on an erectile dysfunction. Erectile dysfunction is often the first warning sign of vascular disease and thus a possible harbinger from heart attack or stroke. If atherosclerosis is detected and treated early, Often bad consequences can be avoided. Not least for this reason, it is advisable to clarify a potency problems medically.

Testosterone deficiency

The male sex hormone testosterone seems to have a significantly greater impact on the love life as long suspected. This is shown by recent research results. So is a sufficiently high hormone level apparently a very important condition for a satisfactory erection. With the years of life, testosterone levels in the blood usually fall off in men. A testosterone deficiency (hypogonadism) does not have, but may well lead to impotence. Therefore, if men have erection problems, they should necessarily also have low testosterone levels as a possible cause be considered.

Drug side effects

Important to know: Many medications can cause impotence as a side effect, including beta-blockers for high blood pressure, dehydrating medications, lipid-lowering drugs or depression medications. If there is an indication in the instruction leaflet and there is a suspicion that the remedy might be a cause of erectile dysfunction, patients should consult their physician. Maybe he can prescribe another drug. Caution: Do not discontinue or change medication on your own!

Other causes

For an erection to come, not only the penis circulation must be right. All involved nerve tracts - from the penis to the spinal cord to the brain - must be intact. Herniated discs, injuries, radiation or pelvic or spinal cord surgery can cause erectile dysfunction. Also, diseases that can cause damage to peripheral nerves (a neuropathy) - such as diabetes mellitus (diabetes) or chronic alcohol abuse. Other possible causes of erectile dysfunction include diseases affecting the central nervous system, such as multiple sclerosis, Parkinson's disease, Alzheimer's disease or stroke. Serious diseases - such as cancer, severe kidney or liver disease - can always affect the potency with.

Psychic triggers

Physical and emotional triggers can be mixed in erectile dysfunction. If men suffer from physical problems with potency, they easily develop additional psychological problems. Purely psychologically caused causes can be found especially in younger men. In addition to conflicts in the partnership, stress, problems or anxiety disorders, depression is very often with associated with erectile dysfunction. In erectile dysfunction, the man can not get or maintain an erection sufficient for intercourse. The penis does not get hard enough and / or recovers quickly. The problems last for at least six months and occur in more than two-thirds of the cases. Often, erectile dysfunction (commonly called "impotence") gradually develops and occurs both in intercourse with the partner and in masturbation. This constellation indicates physical causes such as vascular changes (see chapter Causes). In every healthy man, erections occur in certain phases of sleep. If they stay out, this is another indication of physical causes. Does it only in very specific situations to erectile dysfunction and they are very sudden - almost from one day to the other - are the possible (but not proving) signs of psychic trigger.

Balance testosterone deficiency

With increasing age, the testosterone level in the blood drops slightly in almost all men. This is nothing unusual and no reason for a therapy. However, if a man suffers from erectile problems, a testosterone deficiency (hypogonadism) could play a decisive role. In this case, the doctor will advise to balance the hormone deficiency. Maybe this will already improve the potency problems. Often, erectile dysfunction medications (PDE-5 inhibitors, see below) are better or first in combination with hormone therapy. Some men with erectile dysfunction even benefit from testosterone supplements, although her blood levels are actually in a near normal range. When does the hormone supplement make sense? It should therefore be decided individually - jointly by doctor and patient. The testosterone is applied in the form of a gel on the skin or sprayed at greater intervals in the muscle. At first, research seemed to indicate that That a testosterone therapy could possibly increase the risk for prostate cancer or a heart attack. However, according to current knowledge such fears are unfounded, say experts - a professional medical treatment provided. Mostly, however, only the symptoms, not the actual triggers of erectile dysfunction can be treated. There are various options, from medication to mechanical aids. What helps best in an individual case is an individual decision the after extensive consultation on possible side effects and risks together with the doctor - and ideally, of course, together with the partner - should be taken. Patients themselves can help to maintain or even improve their potency for a long time. What keeps the blood vessels fit also prevents erectile dysfunction. In detail this means: Do not smoke, eat well, drink little alcohol, move a lot, lose weight, blood pressure, Check blood sugar and blood lipids regularly and treat them with bad results.

Drugs

In Germany, various phosphodiesterase 5 inhibitors (PDE-5 inhibitors) are approved for the treatment of erectile dysfunction: the first was sildenafil, which was launched in 1998. Tadalafil, Vardenafil and Avanafil followed. All are prescription. Effect and side effects are roughly comparable. The tablets help about 70 to 80 percent of "impotent" men and differ mainly in dosage and duration of action. Sildenafil, vardenafil and avanafil work after about 15 to 60 minutes (the onset of effect may be delayed after high-fat meals). Their effect lasts around four to twelve hours. Tadalafil works after about 30 minutes for about 24 to 36 hours. This medication can also be prescribed as a permanent medication with one tablet a day. As the name suggests, the drugs inhibit phosphodiesterase-5 (PDE-5), which is an endogenous enzyme. This enzyme normally breaks down a certain messenger substance, which increases in sexual arousal and increases blood circulation in the penis. If the enzyme phosphodiesterase-5 is now obstructed in its work by the drugs, there is more messenger left. Consequently, penile blood flow increases, an erection develops or persists longer. A second effect is that the blood pressure in the pulmonary circulation drops. Phosphodiesterase 5 inhibitors are therefore also used to treat pulmonary hypertension. PDE-5 inhibitors only work if the man is sexually aroused. So you do not increase the desire. The erection ends - as without medication - with orgasm or ejaculation. Within the duration of action, however, further erections are possible. Possible side effects include headache, facial flushing, heartburn, stuffy nose, Transient changes in color vision in sildenafil and vardenafil, in Tadalafil also muscle and back pain. Exact information can be found in the leaflet. Not suitable are PDE-5 inhibitors for patients prescribed by the doctor nitrates or molsidomine, because it can lead to a dangerous drop in blood pressure here. Nitrates or molsidomine, for example, in the treatment of angina pectoris in coronary Heart disease used. Some diseases (for example, severe liver disease, Heart disease or a stroke in the past) may speak against taking PDE-5 inhibitors. The PDE-5 inhibitors are good for a prescription. Before the first application, patients should consult the doctor extensively on side effects and inform possible individual risks. Another drug for the treatment of erectile dysfunction is yohimbine, which acts in the brain and especially for psychically induced potency disorders is used.

Viagra There are 5 products.

What is avanafil or spedra?

For the following application areas of Avanafil, in-depth information is available:

- erectile Dysfunction

Please also read the information on the drug classes Potency, Phosphodiesterase, to which the active ingredient avanafil belongs. Areas of application according to the manufacturer's instructions

- Erectile dysfunction in adult men

dosage of spedra

The recommended dose is one 100 mg tablet taken by the man when needed approximately 30 minutes before sexual activity. Depending on individual efficacy and tolerability, the dose may be increased to a maximum of one 200 mg tablet or reduced to a 50 mg tablet.

The recommended maximum frequency of use is once a day. For a sufficient effect sexual arousal is required.

Particularities:Patients whose erection lasts four hours or more (priapism) should consult a doctor immediately. Left untreated, priapism damages the penis tissue, which can lead to permanent loss of potency.

Interactions of avanafil

Avanafil enhances the antihypertensive effects of nitro-based vasodilators. Therefore, the joint application is prohibited. If a patient who has taken avanafil within the last 12 hours or more has been given nitrates because of a life-threatening situation (such as a heart attack), the blood pressure may be lowered.

Avanafil has a vasodilating effect on the penis, but this effect can affect the whole body. Therefore, the drug increases the blood pressure reduction by appropriate drugs (alpha sympatholytic, calcium channel blocker). It can cause dizziness, drowsiness or fainting.

Avanafil is degraded by an easily influenced enzyme system. Therefore, the application is prohibited with strong inhibitors of these enzymes. These include: the fungicides itraconazole and ketoconazole, the antiviral agents atazanavir, indinavir, nelfinavir, ritonavir and saquinavir, the antibiotics clarithromycin and telithromycin and the antidepressant nefazodone.

Patients receiving at the same time weaker inhibitors of this enzyme (the antibiotic erythromycin, the antifungal agent fluconazole, the antiviral agents amprenavir and fosamprenavir, aprepitant (for nausea and vomiting), and the antidiabetic diltiazem or verapamil but also grapefruit juice) should not exceed the maximum dose of avanafil (100 Milligrams). Between the individual revenues should be a time interval of at least 48 hours.

Consuming alcohol while using spedra may increase the likelihood of a sudden drop in blood pressure. Therefore, you should abstain from drinking while taking.

Drugs that accelerate the degradation of avanafil may affect its performance. These include the antiepileptic drugs carbamazepine and phenobarbital, the tuberculosis drug rifampicin, the antiviral agent efavirenz and bosentan (for pulmonary hypertension). Although there are no studies, but should be avoided as a precaution, the joint application.

1. WHAT IS DAPOXETINE AND WHAT IT IS USED FOR?

• Dapoxetine is a drug in tablet form containing the active ingredientContains dapoxetine. It is used to treat prematureEjaculation (Ejaculatio praecox) applied. Dapoxetine isapproved for men between 18 and 64 years.• Dapoxetine (dapoxetine) is a serotonin reuptake inhibitor(SSRI). Previous research has shown that serotoninplays a central role for the ejaculation time.• Dapoxetine blocks transportsubstances that serotonin aftersignal transmission back into the memory locationsreturn the parcel. Serotonin stays longer at the site of action, andits effectiveness increases. SSRIs are mainly so farfor the treatment of depressiveUsed diseases. in theUnlike dapoxetine, one to three hours before sexhowever, these antidepressants must be takenbe used regularly and over a longer period of time.

2. WHAT DO YOU NEED BEFORE TAKING DAPOXETINENOTE?

Important information• Beware of orthostasis! Before the first input shoulda doctor's inclination to oneorthostatic hypotensionexclude. Orthostatic Hypotension (OH) is amorbid blood pressure drop atm getting up from sitting orlying position. The mostHealthy people canhappen that they briefly when raising quicklyWeakness, diffuse Scjib or oneGetting black before the eyes. One only speaksfrom an OH if it constantly occurs and discomfortcaused.• Avoid situations in which there is injurycan come, including driving a car or thatOperating dangerous machinery, syncopation or its should beprodromal symptoms such as dizziness or drowsinessoccur. (*)• It may be too after taking dapoxetineCirculatory problems up to a circulatory collapsecome. * A sufficient Flüfluid intake and theAvoiding alcohol are wiwell, to prevent that!Caution also at the same timeger treatment with medication,the one blood vesselown effect, effectand PDE5 inhibitors (potency agent, sildenafil), alphaAdrenoceptor antagonists, nitrates.• Do not take alcoholwithin 24 hours before or aftertaking Dapoxetine! The risk of side effectsNervous system, heart and circulation can be increased.• Dapoxetine must not be taken with drugsbecome! Especially in combination with ketamine, LSD, MDMA,Amphetamine, narcoticsand benzodiazepinesserious side effects occur.• This medicine kann also under normal conditionsUse the ability to activen participation in road trafficor interfere with the operation of machinery. This is true inincreased degree in interaction with alcohol.• Antidepressants increased the risk in short-term studiessuicidal thoughts in childrenn and teenagers with strongDepression. For Dapoxetine there was no reference to onesuch increased risk.• Dapoxetine was only given to men with premature ejaculationtested. About effect and side effects in men withoutEjaculatio praecox no data available.• Dapoxetine may cause blood clottinginfluences. Be carefulsimultaneous treatment withPlatelet aggregation inhibitors(atypical antipsychotics, Phenothiazines, acetylsalicylic acid,NSAIDs) or anticoagulants (Warfarin). People with bleedingor coagulation disorders are particularly at risk.• A sudden discontinuation von SSRI, which is longerPeriod of administration may cause withdrawal symptomslead, for example, irritable barkit, bad mood, dizziness,Nervousness, insomnia andA headache. When weaningof Dapoxetine showed no or only slight in studiesWithdrawal symptoms.

3. HOW TO TAKE DAPOXETINE?

• The initial dose is 1 tablet to 30 mg 1 to 3 hours beforesexual activity.• Do not take DAPOXETINE more than once a day!• Take with a glass of water with or without food.• An increase to 60 mg is possible if the effect is notsufficient and the side effects are tolerable. atorthostatic reaction to diDo not increase the 30 mg dose!• The medicine is not for daily long-term therapysuitable.

5. HOW TO STORE DAPOXETINE?

Store drug out of reach of children.You are allowed to use DAPOXETINE after the carton and theDo not use the expiry date given on the blister pack.Keep in original packaging to preview the contentsMoisture protection .. Do not store above 25 ° C.The drug must not be in wastewater or household wastebe disposed of. Ask your pharmacist how the medicine worksis to be disposed of when you no longer need it.

What is Sildenafil viagra?

Viagra or sildenafil will be used to treat adults to men with erectile dysfunction applied. That's the inability, one for a satisfying sexual intercourse to achieve sufficient erection or uphold. sildefanil can only work if a sexual stimulation is present How to use viagra? The recommended dose is 50mg, it is about 1 hour before sexual intercourse to take it. According to the sity and compatibility The dose can be reduced increased to 100 mg or reduced to 25 mg become. The recommended maximum dose is carries 100 mg. The intake must not be frequent. than once a day. If VIAGRA taken with food is, the impact can be compared be delayed for fasting. Effects of sildenafil? Sildenafil provides an oral treatment of the erectile dysfunction. In a natural way, through sexual stimulation, the impaired erectile function due to an increase in the blood stream into the penis restored. The man responsible for the erection of the penisThe physiological mechanism closes the release of nitric oxide (NO)in the corpus cavernosum during the se-xual stimulation. The nitrogen mono-oxide activates the enzyme guanylate cyclase,waszuerhöhtenSpiegelnanzyklischemGuanosine monophosphate (cGMP) leads. Here-through it comes to a relaxation ofsmooth muscles in the corpus cavernosum,which allows the blood to flow.Sildenafil is an effective and selectiveInhibitor of the cGMP-specific phosphorusphodiesterase type 5 (PDE5) in the corpusvernosum, where they work for the removal of cGMPresponsible for. sildenafil has a peripheral effectErections. Sildenafil does not practice directrelaxing effect on isolated humanCorpus cavernosum tissue, itbut enhances the relaxing effectNO on this tissue. If undersexual stimulation the activation of theNO / cGMP metabolic pathway takes place,causes PDE5 inhibition by sildenafilincreased cGMP levels in the corpus cavernossum. Therefore, a sexual stimulationnecessary for sildenafil to do the intendedcan develop favorable pharmacological effect. Viagra causes a small and temporarygoing reduction in blood pressure, which inin most cases no clinically relevantApparitions result. On average,contributed the maximum blood pressure decreaseslying down after taking 100 mg of Silicadenafil systolic 8.4 mmHg, diastolic5.5 mmHg. This blood pressure reduction reflectsthe vasodilator

Effect of sildenafil

reflected, possibly due to increasedcGMP level in the smooth muscle vascularmusculature. Single oral doses of up to 100 mgSildenafil showed in healthy volunteersno clinically relevant ECG changesgene.In a study on the hemodynamicEffects of a single oral dose ofSildenafil 100 mg in 14 patients withSevere (> 70% stenosis at leastcoronary artery) coronary heart disease(KHK) took the middle systolicand the mean diastolic blood pressure inRest to the baseline around7% and 6% respectively. The middle pulmonarysystolic blood pressure decreased by 9%.Sildenafil did not affect the cardiacit still affected theBlood flow into the stenosed coronaryarteries.In a double-blind placebo-controlledThe load study included 144 patientswith erectile dysfunction and stable chroangina pectoris, theantianginal medication (exceptNitrates). Under sildenafil occurred in theCompared to placebo, no clinically relevantdifferences in the time toOccur an abortion-compelling angina.

Side effects of viagra?

Summary of the security profile The safety profile of VIAGRA is based on 9,570 patients from 74 double-blind place- bokontrollierten clinical trials. The most commonly described side effects in patients treated with sildenafil in clinical trials were headaches, Flush, dyspepsia, stuffy nose, dizziness del, nausea, hot flash, blurred vision, Cyanopsia and blurred vision.

1. What is CIALIS Tadalafil and what is it used for?

CIALIS is used to treat adult men with erectile dysfunctionapplied. This is the case when a man does not have sexual activitycan get or maintain a hard, erect penis. CIALIS showed onesignificant improvement, a hard, erect penis for sexual activity tooto get.CIALIS contains tadalafil as an active ingredient and belongs to a group of medicinescalled the "phosphodiesterase 5 inhibitors". After a sexualStimulating Tadalafil helps to relax the blood vessels in your penisBlood flow into your penis is possible. The result is an improved erection.CIALIS will not help you if you are not suffering from erectile dysfunctionSuffer.It is important to note that CIALIS does not work without sexual stimulation. OnPartnership foreplay may be necessary, as if you were not a medicineagainst erectile dysfunction.

2. What should you watch out for before taking CIALIS?

CIALIS must not be taken if you:- allergic to tadalafil or any of the otherComponents of this medicine are.- in any form organic nitrates or nitrogen oxide donors such as amyl nitritetaking. This is a group of medicines ("nitrates") that are used for treatmentof angina pectoris (certain type of "heartache") are used. ItCIALIS has been shown to enhance the effects of these drugs. If youtake some form of nitrates, or are unsure, speakwith your doctor.- suffer from a serious heart condition or one in the last 90 daysHad heart attack.- had a stroke in the last 6 months.- suffer from low or uncontrolled high blood pressure.- ever a vision loss due to a non-arteritic anteriorIschemic optic neuropathy (NAION), this disease is known as"Stroke of the eye" described.- Take riociguat. This medicine is used for treatmentof pulmonary arterial hypertension (i.e., high blood pressure in the lung) andChronic thromboembolic pulmonary hypertension (i.e., high blood pressurein the lungs in addition to blood clots). PDE5 inhibitors, such as Cialishave been shown to increase the antihypertensive effect of this drug.If you are taking riociguat or are unsure, talk to your doctor

3. How to take Tadalafil?

Always take this medicine exactly as your doctor has told you.Ask your doctor or pharmacist if you are not sure.CIALIS tablets are to be taken by men only. Swallowthe whole tablet with a little water. You can use CIALIS independently of theTake meals.The recommended starting doseis a 10 mg tablet before sexual activity.If the effect of this dosage is too low, your doctor may decide the dosageincrease to 20 mg.You should take CIALIS at least 30 minutes before sexual activity.CIALIS can work for up to 36 hours after taking the tablet.Do not take CIALIS more than once a day. Tadalafil are 10 mg and 20 mgIntended to be taken before expected sexual activity and dailyIntake for a long time is not recommended.It is important to note that Tadalafil only works with sexual stimulation. OnPartnership foreplay may be necessary, as if you were not a medicineagainst erectile dysfunction.Alcohol consumption can affect your ability to get an erection andcan also temporarily lower your blood pressure. If you taken CIALISor if you plan to take CIALIS, avoid overeatingDrink (blood alcohol level of 0.8 ‰ and more), because this reduces the risk ofDizziness when getting up can be increased.If you take more Tadalafil than youshouldTell your doctor. It could be that side effects occur, like in theSection 4. described.If you have any further questions on the use of this medicine, please contactto your doctor or pharmacist.

4. What side effects are possible with Tadalafil?

Like all medicines, this medicine may also have side effectsbut do not have to occur at everyone. These are usually mild to moderate.Stop the treatment and notify a doctor immediately ifYou notice any of the following side effects:- allergic reactions, including rashes (uncommon).- Chest pain - Do not use nitrates, take them immediatelymedical assistance (frequency uncommon).- Priapism, a prolonged and possibly painful erection canoccur after ingestion of CIALIS (frequency rare). Should you have an erectionIf you have more than 4 hours, contact your doctor immediatelyDoctor in contact.- sudden loss of vision (frequency rare).Other side effects have been reported:Frequently(may affect up to 1 in 10 people)- Headache, backache, muscle aches, pain in theArms and legs, facial flushing, stuffy nose and indigestion.Occasionally(may affect up to 1 in 100 people)- Dizziness, abdominal pain, nausea, vomiting, acid regurgitation (refluxstomach acid), blurred vision, eye pain, difficultybreathing, blood in urine, prolonged erection, palpitations, tachycardia (fasterHeartbeat), high blood pressure, low blood pressure, nosebleeds, ear noises(Tinnitus), swelling of hands, feet or joints and fatigue.Rare(may affect up to 1 in 1000 people)- Fainting, seizures and temporary memory loss,Swelling of the eyelids, red eyes, sudden deafness orNumbness, hives (itchy, red ridges of the skin), penile bleeding, bloodin the sperm and increased sweating.Heart attacks and strokes have been rare in patients taking CIALISreported. Most of these men already had this before taking thisArzeimittel known heart disease.Partial, temporary or permanent deterioration or loss ofEyesight of one or both eyes has been rarely reported.Some more rare side effectsnot seen in clinical trialswere reported in men who had taken CIALIS. These include:- Migraines, facial swelling, severe allergic reactions,which cause swelling in the face or neck, seriousRedness, some diseases that affect the blood flow to the eye,irregular heartbeat, angina (heart attack) and sudden cardiac death.

5. How to store CIALIS?

Keep Tadalafil out of the sight and reach of children.You must take this medicine after the carton and the blister packafter 'verw. until 'or' EXP 'specified expiry date